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https://wslhd.intersearch.com.au/wslhdjspui/handle/1/5143
Title: | Central nervous system cryptococcal infections in non-HIV infected patients |
Authors: | Beardsley, J.;Sorrell, Tania C.;Chen, Sharon C-A. |
WSLHD Author: | Sorrell, Tania C.;Chen, Sharon C-A. |
Subjects: | Infectious Diseases and Microbiology |
Issue Date: | 2019 |
Citation: | Journal of Fungi. 5(3):71, 2019 Aug |
Abstract: | Central nervous system (CNS) cryptococcosis in non-HIV infected patients affects solid organ transplant (SOT) recipients, patients with malignancy, rheumatic disorders, other immunosuppressive conditions and immunocompetent hosts. More recently described risks include the use of newer biologicals and recreational intravenous drug use. Disease is caused by Cryptococcus neoformans and Cryptococcus gattii species complex; C. gattii is endemic in several geographic regions and has caused outbreaks in North America. Major virulence determinants are the polysaccharide capsule, melanin and several ‘invasins’. Cryptococcal plb1, laccase and urease are essential for dissemination from lung to CNS and crossing the blood–brain barrier. Meningo-encephalitis is common but intracerebral infection or hydrocephalus also occur, and are relatively frequent in C. gattii infection. Complications include neurologic deficits, raised intracranial pressure (ICP) and disseminated disease. Diagnosis relies on culture, phenotypic identification methods, and cryptococcal antigen detection. Molecular methods can assist. Preferred induction antifungal therapy is a lipid amphotericin B formulation (amphotericin B deoxycholate may be used in non-transplant patients) plus 5-flucytosine for 2–6 weeks depending on host type followed by consolidation/maintenance therapy with fluconazole for 12 months or longer. Control of raised ICP is essential. Clinicians should be vigilant for immune reconstitution inflammatory syndrome. |
URI: | https://wslhd.intersearch.com.au/wslhdjspui/handle/1/5143 |
DOI: | https://doi.org/10.3390/jof5030071 |
Journal: | Journal of Fungi |
Type: | Journal Article |
Study or Trial: | Review |
Department: | Center for Infectious Diseases & Microbiology Laboratory Services |
Facility: | Blacktown Westmead Auburn Mental Health, Cumberland ICPMR |
Keywords: | Cryptococcosis Cryptococcus neoformans Cryptococcus gattii central nervous system meningo-encephalitis cerebral infection HIV-negative patients epidemiology antifungal therapy |
Appears in Collections: | Blacktown Mount Druitt Hospital |
Files in This Item:
File | Description | Size | Format | |
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Beardsley-2019-Central nervous system cryptoco.pdf | 312.32 kB | Adobe PDF | View/Open |
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